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NPI Code Detail

MEDICARE: BRYN MULLET GOOD FNP

MEDICARE:   BRYN MULLET GOOD  FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner0024168994VA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1366759250
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRYN MULLET GOOD FNP
Provider Business Mailing Address
First Line : PO BOX 1430
Second Line :
City : HARRISONBURG
State : VA
Zip : 22803-1430
Country : US
Telephone Number : 540-689-4800
Fax Number : 757-579-8630
Provider Business Practice Location Address
First Line : 2275 HEALTH CAMPUS DR
Second Line :
City : ROCKINGHAM
State : VA
Zip : 22801-8809
Country : US
Telephone Number : 540-689-4800
Fax Number : 757-579-8630
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/13/2010
Last Update Date : 02/01/2019

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